quarta-feira, 25 de abril de 2012

Meridian Circuit Systems

Shanghai Museum

Meridian Circuit Systems: A Channel Based Approach to Pattern Identification

In
a meridian based approach to pattern identification and treatment
emphasis is placed on understanding the relationships between the
channels, and how the meridian networks connect to the patient’s top
three health concerns. The relationships between the channels are
determined by the traditional Chinese names for the meridians, the
internal-external relationships, and the horary cycle.

To
begin to understand these connections between the channels we need to
start with the six meridian pairs as classified in the six stages of
syndrome differentiation. These are expounded upon in the Shang Han Lun
(On Cold Damage) and include the six pairs of tai yang, yang ming, shao
yang, tai yin, shao yang, and jue yin. Though the Shang Han Lun
discusses these meridians in the context of external cold invasions,
this method of pairing the meridians is also based on yin-yang
relationships, anatomical location, and physiological functions. Taking
the yang ming pair as an example we find that it contains one hand
meridian and one foot meridian. Additionally, these meridians are
located on the most anterior yang portions of the body, and they share
functions in the digestive processes. Similarly, the shao yin pair
includes one hand and one foot meridian, and these channels are located
on the most posterior yin aspects of the body. In terms of
functionality the shao yin governs the most vital fluids of the body,
namely the blood and essence.

Another way the meridians may
be paired is through what is called the Zang Fu Bei Tong Theory (5 Zang
Extra Relationship Theory). This way of pairing meridians is a major
component of Tung style acupuncture and is referred to as the system two
associations in Dr. Tan’s methods. This system takes the tai yang
meridians and pairs them with the tai yin, while the shao yang is
associated with the shao yin, and the yang ming meridians are paired
with the jue yin. It is through this system that the LI and LV
meridians form a connection, and this relationship is most commonly
recognized in the point combination of LI 4 (He Gu) and LV 3 (Tai
Chong).

In addition to the well known internal-external
associations, meridians may also be grouped according to the horary
cycle. In this system each of the twelve regular meridians have a
designated two hour period of time during a 24-hour day. Meridians that
are located opposite the clock of one another may be paired, and
examples of this include the relationships between the LV and SI, the ST
and PC, and the KI and LI. Additionally, the channels may also be
paired when they are located next to each other on the clock and have
the same yin-yang designation. This forms relationships between the LV
and LU, the SP and HT, and the KI and PC.

The systems that
are a fundamental part of meridian systems theory have been described by
several classical and traditional sources, including the Nei Jing
(Inner Classic), the Shang Han Lun, Master Tung, and Dr. Richard Tan.

Four Meridian Circuits

By joining meridian pairs that share correspondence through these
systems, circuits of connection can be formed from four meridians.
These are called four meridian (4M) circuits. As an example the yang
ming may be connected to the tai yin, and this relationship between the
meridians may be represented as:

ST - LI

- -

SP - LU

This image shows how the stomach and large intestine are connected
through the yang ming, while the yang ming connects to the tai yin
through the internal-external relationships. Taken as a whole we may
describe the functions and indications of the yang ming – tai yin
circuit.

The use of this circuit will depend on symptoms that primarily
involve the yang ming and tai yin. This is an earth-metal circuit that
has broad applications when respiratory and digestive symptoms occur
together. This includes food allergies, Candida, asthma, immune
deficiency, and external invasions that affect the lungs and digestive
system.

This circuit may be used for treating patterns such
as spleen qi deficiency, large intestine damp heat, lung qi deficiency,
spleen dampness attacking the lungs, spleen and lung qi deficiency, and
phlegm obstruction of the lungs. The Yang Ming – Jue Yin Circuit

According to the Zang Fu Bei Tong Theory, the yang ming also
connects to the jue yin meridians of the liver and pericardium. In
patterns where the liver is affecting the stomach or large intestine,
the use of the meridians in this circuit are usually sufficient to
address the numerous symptoms and diseases that can arise from these
types of patterns. Notice in this circuit that the LV and LI have a
direct connection. The association between these meridians is widely
acknowledged in the use of four gates (LI 4 and LV 3). It should also
be noted that the ST and PC share a direct connection in this circuit,
and this helps to explain the ability of Nei Guan PC 6 to resolve nausea
and vomiting. The yang ming – jue yin circuit may be represented as:

This
circuit should be used whenever the primary symptoms exist within the
yang ming and occur with liver, pericardium, or qi and blood stagnation
patterns. Proper circulation of the qi and blood is essential to good
digestive health, and when liver patterns present they can easily
influence the stomach and large intestine. This can cause symptoms such
as acid reflux, ulcers, stomach pain, constipation, and IBS. When the
liver is involved in yang ming patterns it is common that the client
will also suffer from excessive stress, frustration, and anger. For
these reasons PC points are an important addition to the treatment since
they have the functions of moving liver qi, calming the mind, and
harmonizing the stomach and intestines.

The jue yin also connects to the shao yang through their
internal-external relationships, and this circuit can be used to treat a
variety of patterns including liver yang rising, liver fire, liver qi
stagnation, and liver/gallbladder damp heat.

This circuit is often used when the shao yang meridians are in a
state of disharmony and manifest with symptoms in the head, neck,
throat, shoulders and hips. Shao yang symptoms will usually occur with
jue yin patterns due to the internal-external relationship they share.
It is often the case that liver patterns will influence the GB meridian
and present with symptoms such as temple headaches, neck tension, eye
disorders, and insomnia.

This circuit is also very powerful
for clearing internal heat and fire that is located in the shao yang and
jue yin meridians. Liver fire will often manifest with GB meridian
symptoms, and the SJ is effective for relieving symptoms associated with
both the gallbladder and liver. When liver fire is present, needling
the SJ helps to clear fire, while the PC meridian clears heat and
resolves liver stagnation.

Refining Pattern Identification and Treatment Strategies

The use of the meridian circuits can greatly aid in fine-tuning the
process of pattern identification and the corresponding treatments that
result. For example, liver qi stagnation can cause a variety of
symptoms, and not every patient will manifest all the symptoms that
characterize the pattern of liver qi stagnation. Some clients with
liver stagnation will experience symptoms such as abdominal pain and
constipation. For patients like this the yang ming – jue yin circuit
would be the optimum one to use, since it contains meridians that will
address the root pattern, as well as treat the organs that have the
symptomatic expressions. However, for a client that has liver qi
stagnation but experiences symptoms such as temple headaches, neck pain,
and shoulder tension, it is best to use the jue yin – shao yang
circuit. This is because the shao yang meridians pass through these
areas and can easily be affected by imbalances originating in the
liver. For this reason the use of the jue yin – shao yang circuit is
often a good choice for neck and shoulder conditions, especially when a
liver pattern results in symptoms in the gallbladder and/or san jiao
meridians.

Meridian Circuit Systems

The use of the 4M circuits constitutes a complete system of pattern
identification that is based on the connections between the meridians.
When we analyze all the possibilities of 4M circuits that may be formed
we find that there are a total of fifteen. By asking the patient about
their top three health concerns, and identifying what meridians and
organs are expressing symptoms, it is possible to identify which one of
the fifteen 4M circuits is most out of balance. By combining this
method of pattern identification with more conventional forms like
zang-fu and 5-elements, it is possible to arrive at a more accurate
diagnosis and have a more complete picture of pathological imbalances
that are present. This can greatly help to improve the clinician’s
selection of meridians and points to be treated, while increasing
clinical efficiency with the use of fewer needles.